Teaching students 'realistic medicine'

Medical education and ambulatory care are not mutually exclusive to cost effectiveness. Rather they can, and should be, concurrent goals that do not compromise the quality of either product. In order to maximize this opportunity, the mutual cooperation of faculty, administration, and support staff are mandatory. Synergistic efforts result in a superior and relevant product--well-trained, primary care physicians prepared to practice cost effective and quality medicine in the office. Experience at the Medical Center indicates that disinterest or neglect by educators will not influence cost nearly as much as the quality of care and relevance of the educational experience. To do so due to a real or imagined lack of resources is a disservice to patients, community and society, and does not recognize the longer-term fiscal consequences on us all. The institutional challenge to medical schools is to examine the potential for training physicians at sites most resembling the realistic practice of office-based medicine and to then take full advantage of the opportunity. The University of Oklahoma Tulsa Medical Center affords the faculty and students an innovative national model for cost conscious, relevant and transferable primary care medical education programs.